A chemical treat­ment to do in hid­den Uti-caus­ing bac­te­ria

Chi­tosan, a chemical, can help fight per­sis­tent uri­nary tract in­fec­tions by ex­pos­ing dor­mant pathogens to an­tibi­otics

TRA­DI­TION­ALLY, uri­nary tract in­fec­tions ( UTI) have been treated with an­tibi­otics. But de­spite the treat­ment, some­times bac­te­ria can hide in the blad­der and form a dor­mant reser­voir of pathogens. These reser­voirs can later re­lease a burst of in­fect­ing pathogens and cause recurring in­fec­tions.

A group of sci­en­tists from the US and Slove­nia claim to have found a way to get rid of these hard- to- reach bac­te­ria. Work­ing with mice, the team found that in the pres­ence of a chemical called chi­tosan these hid­ing bac­te­ria can be forced to come out in the open, in­side the blad­der. This makes them amenable to an an­tibi­otic treat­ment.

The team started with test­ing the ef­fects of chi­tosan on the growth and sur­vival of a com­mon UTI- caus­ing bac- teria. They found that chi­tosan af­fected the way bac­te­ria at­tached it­self to the in­ner walls of uri­nary tract. Armed with this piece of in­for­ma­tion, they de­cided to test the ef­fects of chi­tosan in the blad­der of mice. For this, mice were anaes­thetised and chi­tosan was in­tro­duced in the blad­der via a catheter.

The study was led by Matthew Blango from the Di­vi­sion of Mi­cro­bi­ol­ogy and Im­munol­ogy, Univer­sity of Utah, US. He says, “Chi­tosan causes a re­lease of the bac­te­ria from the cells lin­ing the blad­der wall be­cause it pro­vokes the host cell to di­vide. We found that cou­pling a chi­tosan treat­ment with an an­tibi­otic treat­ment of sparfloxacin or ciprofloxacin for seven days helped clear the ma­jor­ity of the bac­te­ria from the blad­der. The team is now try­ing to fine tune their chi­tosan and an­tibi­otic method of treat­ing UTIs. He adds, “Our col­lab­o­ra­tors in Slove­nia are in the be­gin­ning stages of try­ing to test chi­tosan in hu­man pa­tients. We have no data to re­port at this time, though.”

There are ex­perts who do not share Blango’s op­ti­mism. Vivekanand Jha, pro­fes­sor of nephrol­ogy, PGIMER, Chandigarh, and sec­re­tary of In­dian So­ci­ety of Nephrol­ogy, says, “The method is very far from any clin­i­cal ap­pli­ca­tion and, in fact, may never come to that stage be­cause there are a num­ber of is­sues in terms of clin­i­cal de­liv­ery and ap­pli­ca­bil­ity in the ap­proach.” He does ac­cept that a so­lu­tion is needed.

“The big­gest chal­lenge is the emer­gence of re­sis­tant or­gan­isms, which means that the drugs that used to work well in the past are no longer ef­fec­tive,” says Jha. In the 1990s, the sit­u­a­tion was not so bad and a case of un­com­pli­cated UTI could be cured within three days, he says. But in the past 20 years avail­abil­ity of new an­tibi­otics, cheap gener­ics and a com­plete lack of an­tibi­otic pol­icy have fa­cil­i­tated ram­pant an­tibi­otic abuse. “In the past five years or so, the prob­lem has reached alarm­ing pro­por­tions,” says Jha.